Gear up For 2026 Medicare Annual Open Enrollment

Medicare Annual Open Enrollment is drawing near, and in late September, you should receive your Annual Notice of Change, a document you should study carefully. It lists any updates coming to your health plan next year, including changes to its physician network and drug coverage.

According to a report by the Kaiser Family Foundation, just three in 10 Medicare beneficiaries review their coverage during this period, which runs from Oct. 15 to Dec. 7 each year.

While it's tempting to just let your plan auto-renew, it could end up costing you if you have a Medicare Advantage plan that drops your personal physician or preferred medical facility from its network.

During open enrollment, you may:

• Switch from Original Medicare to a Medicare Advantage plan or vice versa.

• Change from one MA plan to another.

• Move from an MA plan without drug coverage to one with drug coverage, or the reverse.

• Enroll in a Medicare prescription drug plan. If you did not enroll when you first became eligible for Medicare, you may be charged a late enrollment penalty every year going forward.

• Switch from one Medicare drug plan to another.

• Quit your Medicare prescription drug coverage.

• Apply for Medicare supplement insurance (Medigap) if you are on Original Medicare or returning to it from an MA plan. However, if you are enrolling in a Medigap policy for the first time, you may face higher premiums and could be denied coverage.

Changes for 2026: what we know so far

MA plans can change from year to year, from the doctors who are in-network to the cost of your prescription drugs, so it is wise to compare plans to make sure you are still in the right one.

While Part B and D premiums have not yet been finalized for 2026, an analysis by Kiplinger estimates the monthly base Part B premium will be $186.90 for individuals earning up to $109,000 a year, or $218,000 if married and filing jointly.

In 2026, the standard Medicare Part D deductible will be $615, up from $590 in 2025. This means enrollees will pay 100% of prescription drug costs until they have spent $615 on covered drugs. After the deductible is met, the initial coverage phase begins, during which enrollees typically pay a percentage of the cost (for example, 25%) while the plan sponsor and manufacturer cover the remainder.

The annual out-of-pocket spending limit for prescription drugs will be $2,100, an increase from $2,000 in 2025. Once the out-of-pocket maximum is reached, Part D enrollees will have no copays or coinsurance for their covered medications.

What you can do now

You can get a jump start on open enrollment by marking the following in your planner:

Late September — Watch for your Annual Notice of Change in the mail and review it closely. If you have Medicare Advantage, confirm your doctor is still in-network. If you have Part D, check that your preferred medications remain covered.

Mid-October — Annual Open Enrollment starts on Oct. 15. Use the Medicare Plan Finder to review any changes in your plan's coverage, restrictions,

and costs, then compare them to other available plans.

By the end of November — By this time, you should have chosen to either stay with your current plan or switch to a new one. If you change plans, you will be automatically unenrolled from your old plan. Open enrollment ends Dec. 7, but waiting until the last minute increases the risk of complications.

Got questions about your insurance – business or personal? Just pick up the phone! We're here to help whenever you need us.

Alanda Dyer

Phone: 951-297-9052